Virginia Tech Livestock and Poultry Youth Weekend
Registration Form

Print, fill out, detach, and mail by November 17, 2000, to:
Mark L. Wahlberg
Dept. of Animal and Poultry Sciences (0306)
Virginia Tech
372 Litton Reaves Hall
Blacksburg, Virginia 24061

(Please Print or Type)

Contact Person:___________________________________________________________

Address: ________________________________________________________________

Phone:__________________________________________________________________

No. of Youth 9th grade or older			_____________
No. of Adults			_____________
TOTAL PARTICIPANTS			_____________
Registration Fee - $20.00/person/prepaid
TOTAL REGISTRATION			$_____________

Checks Payable to: Virginia 4-H Foundation

Attendance will be limited to the first 250 registrations received. Complete and return the registration soon so you can be at Virginia Tech on December 1 & 2 to learn the latest.

• Youth must be at least 9th grade in school
• Registration fee is $20.00 per person to be prepaid
• Registration fee is nonrefundable unless the entire event is canceled
• Registration forms must be postmarked by November 17, 2000

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